Schlick et al reported a model for predicting venous thromboembolism (VTE) following discharge from a hospitalization involving a hepatectomy for malignancy. The authors are from Northwestern University, American College of Surgeons and Jesse Brown VA Medical Center in Chicago.
Patient selection: post-discharge following hepatectomy for malignancy (primary or metastatic)
Parameters:
(1) body mass index (BMI)
(2) extent of the hepatectomy
(3) renal insufficiency
(4) blood transfusion
(5) non-operative procedural intervention (inclusive of interventional radiology or gastroenterology procedure)
(6) post-hepatectomy liver failure
Parameter
Finding
Beta-Coefficients
body mass index
< 18.5 kg per sq m
0.59
18.5 to 24.9
0
25.0 to 29.9
0.38
>= 30 kg per sq m
0.83
extent of operation
wedge
0
partial hepatectomy
0
left hepatectomy
0.01
right hepatectomy
0.49
trisegmentectomy
0.49
renal insufficiency
no
0
yes
1.67
blood transfusion
no
0
yes
0.57
non-operative intervention
no
0
yes
1.09
post-hepatectomy liver failure
no
0
yes
0.80
value of X =
= SUM(all of the beta-coefficients) - 5.84
probability of post-discharge VTE =
= 1 / (1 + EXP((-1) *X))
Performance:
• The maximum Youden index was 33.3% at a cutoff of > 0.75%.
• The maximum rate of VTE is 40%.
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